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Written by Allen Lawrence, M.D.
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The Diagnoses - What Is Scabies?
Scabies is a common skin rash caused by infestation with Sarcoptes scabies. The infestation can be diagnoses by its symptoms:
- Night time itching.
- Pruritic (itching) vesicles (blister like lesions)
- Pustules (infected lesions) in runs or galleries. These are short irregular marks some 2-3 mm in length. They look as if they were made by a sharp pencil. They are generally found along the sides of the fingers (all) and on the palms of the hand. They can be found about the nipples in females and pruritic papules (bumps) on the scrotum of men.
- Often pruritic papules are also seen on the buttocks.
- Infected papules are quite common.
- Characteristically mites, ova, and black dots of feces are visible microscopically within these runs and galleries.
- The infestation usually spares the head and the neck (although these areas may be involved in infants). The mites while barely visible with the naked eye can be seen on occasion as white dots.
- Scabies is usually acquired either by close contact, wearing infested clothes or sleeping with an infested individual.
- Scabies can affect an entire family.
The diagnoses can be confirmed by the characteristic symptoms and appearance of the runs and galleries. Absolute confirmation is by scraping off a run and direct visualization under the microscope.
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Scabies: Runs and Galleries on Hands
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Scabies: Runs and Galleries on Back
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Sarcoptes Scabies
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What Is the Treatment for Scabies?
Scabies is treated by a process called disinfestation. Several lotion and cream are available to be applied from the neck down to the toes, overnight, and then repeated in one week. The lotion is showered off in the morning. It is important not to over use this medication as it can be toxic.
All bedding and clothing must be laundered (with strong detergent and then doubly rinsed) or dry cleaned. This is usually done immediately. After applying the medicated lotion and awakening in the morning be sure to wash these linens.
Unless treatment is aimed at all affected persons in a family, reinfestations will probably occur.
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Infections-STDs 
